A clear approach: Hemostatic gel as a novel adjunct for pediatric upper gastrointestinal bleeding

Area of Science:

• Pediatric Gastroenterology
• Endoscopic Hemostasis
• Medical Device Technology

Background:

• Pediatric upper gastrointestinal bleeding (UGIB) presents a significant clinical challenge with a notable mortality rate.
• Current endoscopic management strategies for pediatric UGIB involve diverse techniques, including injections, mechanical devices, thermal therapies, and topical agents.
• PuraStat®, a clear hemostatic gel, has demonstrated utility in adult patients for creating a physical barrier for hemostasis without compromising endoscopic visualization.

Purpose of the Study:

• To evaluate the preliminary use and potential benefits of PuraStat® in treating pediatric upper gastrointestinal bleeding (UGIB).
• To assess the feasibility and tolerability of PuraStat® as an adjunct or monotherapy in pediatric UGIB cases.
• To document the application of PuraStat® in a small cohort of pediatric patients with UGIB.

Main Methods:

• A retrospective review of four pediatric cases involving the use of PuraStat® for upper gastrointestinal bleeding.
• PuraStat® was applied as an adjunct to established hemostatic methods (e.g., clip placement, epinephrine injection) in most cases.
• In one instance, PuraStat® was utilized as monotherapy for a large duodenal ulcer and a contained perforation site.

Main Results:

• PuraStat® was observed to be easy to apply and appeared beneficial in achieving hemostasis across the reviewed pediatric cases.
• The hemostatic gel was well-tolerated by the pediatric patients in this limited series.
• In one case, PuraStat® served as monotherapy for a complex lesion, including a duodenal ulcer and contained perforation.

Conclusions:

• The preliminary findings suggest that PuraStat® may be a valuable and well-tolerated option for managing pediatric UGIB.
• Its ease of use and apparent efficacy as an adjunct or monotherapy warrant further investigation.
• Larger studies are necessary to definitively establish the safety and efficacy of PuraStat® in the pediatric population.